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MAY-26-2010 19:54 Service Station Systems 406 933 5282 P.06 <br /> r � <br /> ` MTonitoring System Certification -Pag. A3 <br /> Site Address: 2448 W, Kettleman Ln. Date of Testing/Servicing: 4130/10 <br /> D. Results of Testing/Servicing <br /> Software Version Installed• I <br /> complete the follotivin checklist: <br /> EL Yes 13 No* Is the audible alarm operational? <br /> A Yes ❑ No* Is the visual alarm operational? <br /> do Yes 1J No* Were all sensors visually inspected, functionally tested, and confirmed operational'? <br /> a Yes Q No" Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their proper operation? <br /> D Yes ❑ Nos if alarms are relayed to a remote monitoring station, is all communications equipment(e.g. modem) <br /> a N/A operational? <br /> 0 Yes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br /> N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate <br /> positive shut-down? (Check all that apply) ❑ Sump/Trench Sensors; 0 Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ❑ Yes ❑ No <br /> 0 Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> 9"/A mechanical overfill prevention valve is installed), is the overfill warning atatn, visible and audible at the tank <br /> fill point(s)and operating property? If so, at what percent of tank capacity does the alarm trig=er? <br /> ❑ Yes" a No Was any monitoring equipment replaced? if yes, identify specific sensors, probes, or other equipment replaced <br /> and list the manufacturer name and model for all replacement parts in Section E,below. <br /> ❑ Yes' a No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> El Product;❑ Water_ If yes,describe causes in Section F.,below. <br /> ,a Yes 0 No* Was monitorin system set-up reviewed to ensure proper settings? 64ttach set-up reports, ifa p licable. <br /> 'Yes 0 No* j is all monitoring equipment operational per manufacturer's specifications? <br /> * In Section E below, describe how and when these deficiencies were or will he corrected. <br /> E. Comments: aid ev&�!L/ <br />